| NPI | 1215797717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ R80848) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R80849) |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-05-16 |